From the Guidelines
The use of a 360 degree guardant, also known as a wound protector, is recommended in medical procedures to reduce the risk of surgical site infections (SSIs), particularly in high-risk patients or dirty surgical incisions, as it has been shown to be effective in reducing SSI rates in several studies 1.
Key Points
- Wound protectors, such as the 360 degree guardant, have been shown to reduce the risk of SSIs in patients undergoing abdominal surgery, with a significant protective effect observed in contaminated and clean-contaminated wounds 1.
- The use of dual-ring wound protectors has been found to have a greater protective effect than single-ring protectors, with a relative risk reduction of 52% reported in one study [@63@].
- The effectiveness of wound protectors has been demonstrated in several meta-analyses, including a study by Kang et al. that analyzed 14 randomized controlled trials and found a pooled risk ratio of 0.70 (95% confidence interval, 0.51-0.96) [@61@].
- Another study by Sajid et al. analyzed 18 randomized controlled trials and found that wound edge protectors were associated with a reduced incidence of overall SSI (OR 0.59; 95% CI 0.43–0.81) and superficial SSI (OR 0.42; 95% CI 0.18–0.95) [@62@].
Clinical Considerations
- The use of wound protectors may be particularly beneficial in high-risk patients, such as those undergoing pancreaticoduodenectomies or other complex surgeries, where the risk of SSI is higher [@63@].
- The cost and availability of wound protectors may be a barrier to their routine use, but reserving them for high-risk patients or dirty surgical incisions may help to reduce costs and improve outcomes 1.
- Wound protectors can be used in conjunction with other infection control measures, such as proper wound closure and dressing, to further reduce the risk of SSI.
From the Research
Use of 360 Degree Guardant in Medical Procedures
- The term "360 degree guardant" is not directly mentioned in the provided studies, but the concept of a 360-degree procedure is discussed in the context of Nissen fundoplication, a surgical operation for gastroesophageal reflux disease (GERD) 2.
- In the study on Nissen vs Toupet laparoscopic fundoplication, the Nissen procedure involves a 360-degree wrap around the esophagus, whereas the Toupet procedure involves a 270-degree wrap 2.
- The study found that the Nissen procedure was associated with a higher rate of dysphagia compared to the Toupet procedure, but both procedures were effective in controlling reflux 2.
- There is no direct evidence in the provided studies on the use of a "360 degree guardant" in medical procedures, but the concept of a 360-degree wrap is relevant in the context of Nissen fundoplication for GERD treatment 2.
Related Surgical Procedures
- Other studies discuss various surgical procedures for esophageal conditions, such as oesophagogastrectomies using the EEA circular stapler 3, minimally invasive surgery for esophageal cancer 4, preoperative preparation for esophagectomy 5, and esophagogastric devascularization and transection for bleeding esophageal varices 6.
- These studies provide information on different surgical techniques and approaches for various esophageal conditions, but do not directly mention the use of a "360 degree guardant" 3, 4, 5, 6.